{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "EYEGLASS ACQUISITIONS, INC.",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 2585",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORTAGE",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49081-2585",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "269-373-8878",
"MailingAddressFaxNumber": "269-373-4720",
"FirstLinePracticeLocationAddress": "762 W MICHIGAN AVE",
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"PracticeLocationAddressCityName": "JACKSON",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49201-1978",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "517-782-4409",
"PracticeLocationAddressFaxNumber": "517-782-4555",
"EnumerationDate": "12/14/2006",
"LastUpdateDate": "12/30/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TRAVIS",
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"AuthorizedOfficialMiddleName": "L",
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"AuthorizedOfficialNamePrefix": "MS.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "269-372-0075",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}